E/M Coding Alert - 2009 Issue 10
Become a Master of Time With This Critical Care FAQ
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Article Overview
This article explains critical care time reporting in a question-and-answer format for coders, billers, and clinical documentation staff. It focuses on how to distinguish included and excluded services, how certain discussions with family or others may be treated, and how CPT and Medicare guidance affect reporting of critical care claims.
Why This Topic Matters
Accurate critical care time reporting affects compliance, documentation quality, and claim submission for high-acuity patient encounters. The article highlights areas where CPT and Medicare guidance may not align, making it relevant for anyone responsible for selecting and supporting critical care services.
Article Sections
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What Must I Carve Out of Critical Care Time?
This section discusses services and activities that may need to be excluded from the critical care time total, along with a brief example of time calculation.
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What’s Included in Critical Care Time?
This section outlines broad categories of services that may be considered part of critical care time and addresses documentation-related discussion exceptions under different guidance sources.
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What Is the Minute Minimum for 99291-+99292?
This section compares time thresholds and reporting concepts associated with critical care services under Medicare and CPT guidance.
What You Will Learn
- How critical care time is generally divided into included and excluded components
- How certain discussions with family members or surrogates are treated in critical care timing
- How CPT and Medicare timing guidance are presented for critical care reporting
- How to recognize the general documentation issues that affect critical care claim support
Who Should Read This
- Medical coders
- Billing specialists
- Compliance staff
- Physician documentation staff
- Emergency department coding professionals
Codes Discussed
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